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Sultana M, Paul SK, Nasreen SA, Haque N, Hasan MK, Islam A, Nila SS, Jahan A, Sathi FA, Hossain T, Ferdaus SJ, Aung MS, Kobayashi N. Epidemiological Features of Leptospirosis and Identification of Leptospira wolffii as a Persistently Prevailing Species in North-Central Bangladesh. Infect Dis Rep 2024; 16:638-649. [PMID: 39195000 DOI: 10.3390/idr16040049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Revised: 07/18/2024] [Accepted: 07/20/2024] [Indexed: 08/29/2024] Open
Abstract
Leptospirosis is considered to be the most widespread, yet neglected, re-emerging zoonotic disease caused by infection with a pathogenic species of the genus Leptospira. Although this disease is prevalent in Bangladesh, the recent epidemiological status has not yet been well documented. In this study, we aimed to determine the prevalence of leptospirosis among febrile patients using different diagnostic methods and to characterize the epidemiological features and species of Leptospira in Mymensingh, north-central Bangladesh. Among the blood samples of 186 patients with suspected leptospirosis who met the inclusion criteria, including having a fever for more than 5 days (November 2021-June 2022), 88 samples (47%) were Leptospira-positive according to IgM LAT, IgM ELISA, or nested PCR (positivity rates: 38%, 37%, and 42%, respectively). Nested PCR showed a significantly higher positivity rate (54%) in patients with a short fever (5-10 day) than the other methods did, with lower rates among those with a longer fever. Leptospirosis cases were more common in males (68%), those 16-45 years of age (70%), residents of rural areas (81%), and farmers (41%). In addition to a fever, myalgia and jaundice were found in more than 70% of the patients, while variable symptoms were observed. The 16S rRNA sequencing analysis revealed that the Leptospira species in all the 22 samples tested were L. wolffii, belonging to the pathogenic subclade P2. This study showed the recent epidemiological features of leptospirosis in Bangladesh, indicating the presumptive predominance of L. wolffii since 2019.
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Affiliation(s)
- Monira Sultana
- Department of Microbiology, Nilphamari Medical College, Nilphamari 5300, Bangladesh
| | | | | | - Nazia Haque
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Md Kamrul Hasan
- Department of Ophthalmology, Sirajganj 250 Bed Bongamata Sheikh Fazilatunnesa Mujib General Hospital, Sirajganj 6700, Bangladesh
| | - Arup Islam
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Sultana Shabnam Nila
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Afsana Jahan
- Department of Microbiology, Pabna Medical College, Pabna 6602, Bangladesh
| | - Fardousi Akter Sathi
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Tasmia Hossain
- Department of Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Syeda Jannatul Ferdaus
- Department of Oral Microbiology, Mymensingh Medical College, Mymensingh 2200, Bangladesh
| | - Meiji Soe Aung
- Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
| | - Nobumichi Kobayashi
- Department of Hygiene, School of Medicine, Sapporo Medical University, Sapporo 060-8556, Japan
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Gutiérrez JD, Tapias-Rivera J. Pooled lagged effect of runoff on leptospirosis cases in Colombia. Heliyon 2024; 10:e32882. [PMID: 38988573 PMCID: PMC11234012 DOI: 10.1016/j.heliyon.2024.e32882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 06/10/2024] [Accepted: 06/11/2024] [Indexed: 07/12/2024] Open
Abstract
Leptospirosis is a global zoonotic disease caused by spirochete bacteria of the genus Leptospira. The disease exhibits a notable incidence in tropical and developing countries, and in Colombia, environmental, economic, social, and cultural conditions favor disease transmission, directly impacting both mortality and morbidity rates. Our objective was to establish the pooled lagged effect of runoff on leptospirosis cases in Colombia. For our study, we included the top 20 Colombian municipalities with the highest number of leptospirosis cases. Monthly cases of leptospirosis, confirmed by laboratory tests and spanning from 2007 to 2022, were obtained from the National Public Health Surveillance System. Additionally, we collected monthly runoff and atmospheric and oceanic data from remote sensors. Multidimensional poverty index values for each municipality were sourced from the Terridata repository. We employed causal inference and distributed lag nonlinear models to estimate the lagged effect of runoff on leptospirosis cases. Municipality-specific estimates were combined through meta-analysis to derive a single estimate for all municipalities under study. The pooled results for the 20 municipalities suggest a lagged effect for the 0 to 2, and 0-3 months of runoff on leptospirosis when the runoff is < 120 g/m2. No effect was identified for longer lagged periods (0-1, 0 to 4, 0 to 5, and 0-6 months) or higher runoff values. Incorporation of the multidimensional poverty index into the meta-analysis of runoff contributed to the models for the lagged periods of 0-3, and 0-4 months.
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Affiliation(s)
- Juan David Gutiérrez
- Universidad de Santander, Facultad de Ciencias Médicas y de La Salud, Instituto Masira, Bucaramanga, Santander, Colombia
| | - Johanna Tapias-Rivera
- Universidad de Santander, Facultad de Ciencias Exactas, Naturales y Agropecuarias, Grupo de Investigación en Ciencias Agropecuarias-GICA, Bucaramanga, Santander, Colombia
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Chee HY, Lam JY, Yaacob M. Tapered optical fiber DNA biosensor for detecting Leptospira DNA. ASIAN PAC J TROP MED 2023. [DOI: 10.4103/1995-7645.372293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/30/2023] Open
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New Genetic Variants of Leptospira spp Characterized by MLST from Peruvian Isolates. J Trop Med 2022; 2022:4184326. [PMID: 36249734 PMCID: PMC9553527 DOI: 10.1155/2022/4184326] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 06/26/2022] [Accepted: 08/03/2022] [Indexed: 11/17/2022] Open
Abstract
Leptospirosis is a zoonotic disease caused by the genus Leptospira, presenting complex and dynamic epidemiology. To determine the genetic variability and its phylogenetic relationship of Leptospira spp isolates from three sources in Iquitos (Peruvian Amazon) from 2002 to 2013, seven MLST genes were analyzed to obtain the Sequence Type (ST) and these sequences were concatenated for phylogenetic analysis. The genetic relationship between STs was determined with the goeBURST algorithm and genetic diversity was determined using DnaSP. Of 51 isolates, 48 were pathogenic belonging to five different species: Leptospira interrogans Nascimento 2004, Leptospira santarosai Feil 2004, Leptospira noguchii Haake 2021, Leptospira borgpetersenii Levett 2021, and Leptospira kirschneri Levett 2021. Of 20 STs identified, 60% corresponded to new genotypes circulating only in Peru. The genotypes ST17, ST37, and ST301 were recorded in rodents and humans. A high intraspecific genetic diversity was demonstrated in L. noguchi. The goeBURST analysis revealed three clonal complexes (CCs) and 16 singletons. The STs were found to show high genetic variability and phylogenetic and goeBURST analysis determined that the genotypes found did not form specific groups according to the source of infection or origin, which confirms the zoonotic potential of these STs in an area highly endemic for leptospirosis.
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Pinto GV, Kuppusamy S, Rai P, Kabekkodu SP, Karunasagar I, Kumar BK. Current methods for the diagnosis of leptospirosis: Issues and challenges. J Microbiol Methods 2022; 195:106438. [DOI: 10.1016/j.mimet.2022.106438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 02/26/2022] [Accepted: 02/27/2022] [Indexed: 10/18/2022]
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Philip N, Jani J, Azhari NN, Sekawi Z, Neela VK. In vivo and in silico Virulence Analysis of Leptospira Species Isolated From Environments and Rodents in Leptospirosis Outbreak Areas in Malaysia. Front Microbiol 2021; 12:753328. [PMID: 34803975 PMCID: PMC8602918 DOI: 10.3389/fmicb.2021.753328] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 10/08/2021] [Indexed: 12/22/2022] Open
Abstract
The zoonotic disease leptospirosis is caused by pathogenic species of the genus Leptospira. With the advancement of studies in leptospirosis, several new species are being reported. It has always been a query, whether Leptospira species, serovars, and strains isolated from different geographical locations contribute to the difference in the disease presentations and severity. In an epidemiological surveillance study performed in Malaysia, we isolated seven novel intermediate and saprophytic species (Leptospira semungkisensis, Leptospira fletcheri, Leptospira langatensis, Leptospira selangorensis, Leptospira jelokensis, Leptospira perdikensis, Leptospira congkakensis) from environments and three pathogenic species from rodents (Leptospira borgpetersenii strain HP364, Leptospira weilii strain SC295, Leptospira interrogans strain HP358) trapped in human leptospirosis outbreak premises. To evaluate the pathogenic potential of these isolates, we performed an in vivo and in silico virulence analysis. Environmental isolates and strain HP364 did not induce any clinical manifestations in hamsters. Strain SC295 caused inactivity and weight loss with histopathological changes in kidneys, however, all hamsters survived until the end of the experiment. Strain HP358 showed a high virulent phenotype as all infected hamsters died or were moribund within 7 days postinfection. Lungs, liver, and kidneys showed pathological changes with hemorrhage as the main presentation. In silico analysis elucidated the genome size of strain HP358 to be larger than strains HP364 and SC295 and containing virulence genes reported in Leptospira species and a high number of specific putative virulence factors. In conclusion, L. interrogans strain HP358 was highly pathogenic with fatal outcome. The constituent of Leptospira genomes may determine the level of disease severity and that needs further investigations.
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Affiliation(s)
- Noraini Philip
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Jaeyres Jani
- Borneo Medical and Health Research Center, Universiti Malaysia Sabah, Sabah, Malaysia
| | - Nurul Natasya Azhari
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Zamberi Sekawi
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
| | - Vasantha Kumari Neela
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Selangor, Malaysia
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Seroprevalence of Leptospira among Selected Mammals on a Wildlife Management Area in Louisiana, USA. J Wildl Dis 2021; 58:183-187. [PMID: 34699588 DOI: 10.7589/jwd-d-20-00192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 06/22/2021] [Indexed: 11/20/2022]
Abstract
From August to December 2018, we collected blood samples from 98 individuals of 11 mammal species to examine seroprevalence of leptospirosis at the Sherburne Wildlife Management Area in central Louisiana, USA. Overall, 21.4% of individuals tested positive for antibodies of at least one Leptospira interrogans serovar and six individuals were reactive for two or more serovars. The most prevalent serovar we detected was serovar Bratislava (19.4%), followed by serovar Grippotyphosa (6.1%), serovar Icterohaemorrhagiae and serovar Pomona (2.0%), and serovar Canicola and serovar Hardjo (1.0%). We detected the highest prevalence in fox squirrels (Sciurus niger), hispid cotton rats (Sigmodon hispidus), and feral swine (Sus scrofa), with serovar Bratislava being the most reactive for these three species. Positive samples returned titer results of 100-400 for all species and serovars, with the exception of one feral swine that returned a titer of 1,600 to serovar Bratislava, indicating an active infection. Although the potential effects of leptospirosis on our study species remains unclear, our data contribute information necessary to understand and manage potential risks of Leptospira exposure to wildlife, domestic animals, and humans.
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Philip N, Lung Than LT, Shah AM, Yuhana MY, Sekawi Z, Neela VK. Predictors of severe leptospirosis: a multicentre observational study from Central Malaysia. BMC Infect Dis 2021; 21:1081. [PMID: 34666707 PMCID: PMC8527767 DOI: 10.1186/s12879-021-06766-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2020] [Accepted: 06/01/2021] [Indexed: 11/25/2022] Open
Abstract
Background Leptospirosis is a re-emerging disease with vast clinical presentations, that ranges from subclinical or mild to severe and fatal outcomes. Leptospirosis can be managed well if diagnosed earlier, however, similar clinical presentations by several other febrile illnesses or co-infections, and laboratory diagnostic challenges due to the biphasic nature of the illness, often result in mis- or underdiagnosis, thereby lead to severe illness. Identification of clinical predictors for the severe form of the disease plays a crucial role in reducing disease complication and mortality. Therefore, we aimed to determine the clinical predictors associated with severe illness among leptospirosis patients from Central Malaysia through a prospective multicenter observational study. Methods A prospective multicenter observational study was performed on patients admitted for clinically suspected leptospirosis. Three hospitals namely Hospital Serdang, Hospital Tengku Ampuan Rahimah and Hospital Teluk Intan were included in the study. Among a total of 165 clinically suspected leptospirosis patients, 83 confirmed cases were investigated for clinical predictors for severe illness. Qualitative variables were performed using χ2 and the relationship between mild and severe cases was evaluated using logistic regression. Multivariable logistic regression was used to predict the independent variable for severity. Results Among the 83 patients, 50 showed mild disease and 33 developed severe illness. The mean age of the patients was 41.92 ± 17.99 and most were males (n = 54, 65.06%). We identified mechanical ventilation, acute kidney injury, septic shock, creatinine level of > 1.13 mg/dL, urea > 7 mmol/L, alanine aminotransferase > 50 IU, aspartate aminotransferase > 50 IU, and platelet < 150 × 109/L as factors associated with severe illness. Acute kidney injury, alanine aminotransferase > 50 IU and platelet < 150 × 109/L were defined as the independent factors for severity. Conclusions Lungs, liver and kidney involvement and septic shock were found as the prognostic factors for severe leptospirosis. Acute kidney injury, high level of alanine aminotransferase and low level of platelets were found to be independent predictors of severity.
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Affiliation(s)
- Noraini Philip
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Leslie Thian Lung Than
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Anim Md Shah
- Department of Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Muhamad Yazli Yuhana
- Infectious Diseases Unit, Internal Medicine Department, Universiti Teknologi MARA, Sungai Buloh, 47000, Selangor, Malaysia
| | - Zamberi Sekawi
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia
| | - Vasantha Kumari Neela
- Department of Medical Microbiology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Selangor, Malaysia.
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Fabian E, Wenisch C, Eisner F, Muhr T, Bauer PK, Prein K, Maierhofer U, Lax SF, Krause R, Zollner G, Weihs W, Krejs GJ. Clinical-Pathological Conference Series from the Medical University of Graz : Case No 164: A 46-year-old man with abdominal pain, dyspnea and rapidly progressing multiorgan failure. Wien Klin Wochenschr 2021; 133:731-740. [PMID: 33871688 PMCID: PMC8053743 DOI: 10.1007/s00508-021-01841-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2021] [Indexed: 12/22/2022]
Affiliation(s)
- Elisabeth Fabian
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, Vienna, Austria
| | - Christoph Wenisch
- 4th Department of Internal Medicine with Infectious and Tropical Medicine, State Hospital Klinik Favoriten, Vienna, Austria
| | - Florian Eisner
- Division of Emergency Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Tina Muhr
- Division of Cardiology, Department of Internal Medicine, State Hospital (LKH) Graz II, Graz, Austria
| | - Philipp K Bauer
- Division of Infectious Diseases and Tropical Medicine, Department of Internal Medicine I, Medical University of Vienna, Vienna, Austria
| | - Kurt Prein
- Department of Pathology, State Hospital (LKH) Graz II, Graz, Austria
| | - Urša Maierhofer
- Department of Pathology, State Hospital (LKH) Graz II, Graz, Austria
| | - Sigurd F Lax
- Department of Pathology, State Hospital (LKH) Graz II, Graz, Austria
| | - Robert Krause
- Section of Infectious Diseases and Tropical Medicine, Department of Internal Medicine, Medical University of Graz, Graz, Austria
| | - Gernot Zollner
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria
| | - Wolfgang Weihs
- Division of Cardiology, Department of Internal Medicine, State Hospital (LKH) Graz II, Graz, Austria
| | - Guenter J Krejs
- Division of Gastroenterology and Hepatology, Department of Internal Medicine, Medical University of Graz, Auenbruggerplatz 15, 8036, Graz, Austria.
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Vanithamani S, Akino Mercy CS, Kanagavel M, Sumaiya K, Bothammal P, Saranya P, Prasad M, Ponmurugan K, Muralitharan G, Al-Dhabi NA, Verma A, Vijayachari P, Natarajaseenivasan K. Biochemical analysis of leptospiral LPS explained the difference between pathogenic and non-pathogenic serogroups. Microb Pathog 2021; 152:104738. [PMID: 33529737 DOI: 10.1016/j.micpath.2021.104738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/02/2021] [Accepted: 01/07/2021] [Indexed: 10/22/2022]
Abstract
Lipopolysaccharide (LPS) is the major surface antigen of Leptospira. In this study, the genes involved in the LPS biosynthesis were analyzed and compared by bioinformatics tools. Also, the chemical composition analysis of leptospiral lipopolysaccharides (LPS) extracted from 5 pathogenic serovars like Autumnalis, Australis, Ballum, Grippotyphosa, Pomona, and the nonpathogenic serovar Andamana was performed. Methods used were Limulus amebocyte lysate assay (LAL), gas chromatography-mass spectrometry (GC-MS), fourier transform infrared spectroscopy (FT-IR), and nuclear magnetic resonance spectroscopy (NMR). LAL assay showed a significantly higher level of endotoxicity among pathogenic serovars (~0.490 EU/mL) than that of nonpathogenic Andamana (~0.102 EU/mL). FAMES analysis showed the presence of palmitic acid (C16:0), hydroxy lauric acid (3-OH-C12:0), and oleic acid (C18:0). Palmitoleic acid (C16: 1), and 3- hydroxy palmitate (3-OH-C16:0) was detected only in pathogenic serovars. In contrast myristoleic acid (C14:1) and stearic acid (C18:0) were present in Andamana. FTIR analysis revealed C-O-C stretch of esters, 3°ROH functional groups and carbohydrate vibration range were similar among pathogenic serovars. The NMR analysis reveals similarity for 6 deoxy sugars and methyl groups of Autumnalis, Australis, and Ballum. Further, the presence of palmitoleic acid and 3-hydroxy palmitate may be the significant pathogen-associated predisposing factor. This mediates high osmolarity glycerol (HOG) mediated stress response in leptospiral LPS mediated pathogenesis.
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Affiliation(s)
- Shanmugam Vanithamani
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Charles Solomon Akino Mercy
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Murugesan Kanagavel
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Krishnamoorthi Sumaiya
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Palanisamy Bothammal
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Perumal Saranya
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Muthu Prasad
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Karuppiah Ponmurugan
- Department of Botany & Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh, 11451, Saudi Arabia
| | - Gangatharan Muralitharan
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India
| | - Naif Abdullah Al-Dhabi
- Department of Botany & Microbiology, College of Science, King Saud University, P.O.Box 2455, Riyadh, 11451, Saudi Arabia
| | - Ashutosh Verma
- Lincoln Memorial University, College of Veterinary Medicine, Harrogate, TN, 37752, USA
| | - Paluru Vijayachari
- WHO Collaborating Centre for Diagnosis, Reference, Research and Training in Leptospirosis, Regional Medical Research Centre (ICMR), Port Blair, 744103, India
| | - Kalimuthusamy Natarajaseenivasan
- Medical Microbiology Laboratory, Department of Microbiology, School of Life Sciences, Bharathidasan University, Tiruchirappalli, 620024, India; Department of Neuroscience, Lewis Katz School of Medicine, Temple University, Philadelphia, PA, 19140, USA.
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Dogonyaro BB, van Heerden H, Potts AD, Kolo BF, Lotter C, Katsande C, Fasina FO, Ko AI, Wunder EA, Adesiyun AA. Seroepidemiology of Leptospira infection in slaughtered cattle in Gauteng province, South Africa. Trop Anim Health Prod 2020; 52:3789-3798. [PMID: 33009586 PMCID: PMC10407966 DOI: 10.1007/s11250-020-02417-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 09/24/2020] [Indexed: 11/27/2022]
Abstract
Leptospirosis is an important economical disease of livestock globally, especially in Asia, the Caribbean, and the African continent. Its presence has been reported in a wide range of livestock. However, information on leptospirosis in South Africa is scanty. We conducted a cross-sectional study in 11 randomly selected abattoirs to determine the seroprevalence and risk factors for leptospirosis in slaughtered cattle in Gauteng province, South Africa. During abattoir visits to selected abattoirs, blood samples were collected from 199 cattle and demographic data obtained on the slaughtered animals. The microscopic agglutination test (MAT) was performed on all sera using a 26-serotype panel using cutoff titer ≥ 1:100. Animal- and abattoir-level risk factors were investigated for their association with seropositivity for leptospirosis. The seroprevalence of leptospirosis in the cattle sampled was 27.6% (55/199). The predominant serogroups detected in seropositive cattle were Sejroe (sv. Hardjo) (38.2%) and Mini sv. Szwajizak) (14.5%) but low to Canicola (sv. Canicola) (1.8%) and Pomona (sv. Pomona) (1.8%). The differences were statistically significant (P < 0.05). Of the five variables investigated, only one (abattoirs) had statistically significantly (P < 0.001) differences in the seroprevalence of leptospirosis among abattoirs. The study documented for the first time in South Africa, the occurrence of serogroups Sejroe (Hardjo bovis strain lely 607), Tarassovi, Hebdomadis, and Medanensis in slaughtered cattle. It was concluded that six of the nine serovars (representing seven serogroups) of Leptospira spp. circulating in cattle population in South Africa are not vaccine serogroups. The clinical, diagnostic, and public health importance of the findings cannot be ignored.
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Affiliation(s)
- B B Dogonyaro
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa.
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA.
- National Veterinary Reserch Institute, Department of Virology, Bacteriology and Parasitogy, Vom, Plateau State, Nigeria.
| | - H van Heerden
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - A D Potts
- Bacterial Serology Laboratory: ARC-Onderstepoort Veterinary Research, Pretoria, South Africa
| | - B F Kolo
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
| | - C Lotter
- Bacterial Serology Laboratory: ARC-Onderstepoort Veterinary Research, Pretoria, South Africa
| | - C Katsande
- Gauteng Department of Agriculture and Rural Development, Johannesburg, South Africa
| | - F O Fasina
- Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
- ECTAD, Food and Agriculture Organization of the United Nations, Dar es Salaam, Tanzania
| | - A I Ko
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Brazil
| | - E A Wunder
- Department of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, CT, USA
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Brazilian Ministry of Health, Salvador, Brazil
| | - A A Adesiyun
- Department of Production Animal Studies, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa
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Clinical characteristics, outcomes, and predictors of leptospirosis in patients admitted to the medical intensive care unit: A retrospective analysis. J Infect Public Health 2020; 13:2055-2061. [PMID: 33139235 DOI: 10.1016/j.jiph.2020.10.004] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 08/29/2020] [Accepted: 10/08/2020] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Early diagnosis and detection of clinical deterioration of leptospirosis are challenges to all clinicians. This study aimed to report the characteristics and outcomes of patients admitted to the medical intensive care unit (MICU) for severe leptospirosis and to identify the clinical predictors of MICU admission. METHODS This was a 10-year retrospective study that included all patients diagnosed as leptospirosis, based on either serology or a Thai-Lepto score (TLS) of >4. All clinical characteristics and laboratory data were collected and compared between MICU cases and general ward cases. Binary logistic regression was applied to identify the independent factors for MICU admission. RESULTS Of the 68 patients who were diagnosed as leptospirosis based on inclusion criteria, 43 serologically-confirmed cases were subsequently analyzed. Fifty percent of the cases were admitted to the MICU and, compared with those admitted to the general ward, had higher Sequential Organ Failure Assessment (SOFA) score [10 (7-13) vs. 5 (2.2-5.6), p < 0.001]; higher TLS [7.5 (6.5-9.25) vs. 5.5 (3.5-6.5), p < 0.001]; lower mean arterial blood pressure (74.7 ± 15 mmHg vs. 84.2 ± 16.3 mmHg, p = 0.04); lower platelet count in ×103 cell/mm3 [65 (52.8-105.8) vs. 159 (87.3-181.5), p = 0.008); higher total bilirubin level [4.4 (1.5-8.7) mg/dL vs. 1.2 (0.7-2.8) mg/dL, p = 0.01]; and required more inotropes and vasopressors (87% vs. 4.3%, p < 0.001), mechanical ventilator support (91.3% vs. 4.3%, p < 0.001), and renal replacement therapy (39.1% vs. 0%, p < 0.001). TLS, SOFA score, requirement for mechanical ventilation, and use of inotropes and vasopressors were the predictors of MICU admission. TLS > 6 and SOFA score >6 gave similar power to predict MICU admission. CONCLUSION Among patients with leptospirosis, TLS, SOFA score, inotrope or vasopressor requirement, and mechanical ventilator support were the independent predictors of MICU admission. TLS > 6 and SOFA score >6 indicated the need for MICU admission.
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Vieira ML, Persson S, Lopes-Ferreira M, Romero EC, Kirchgatter K, Nascimento ALTO, Herwald H. Heparin-Binding Protein Release Is Strongly Induced by Leptospira Species and Is a Candidate for an Early Diagnostic Marker of Human Leptospirosis. J Infect Dis 2020; 219:996-1006. [PMID: 30299510 DOI: 10.1093/infdis/jiy589] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 10/06/2018] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Leptospirosis, caused by spirochetes of the genus Leptospira, is one of the most widespread zoonoses worldwide. Efficient diagnostic methods for early diagnosis of leptospirosis are still lacking, and acute disease presents with nonspecific symptomatology and is often misdiagnosed. The leptospires pathogenic processes and virulence mechanisms remain virtually unknown. In severe infections, hemostatic impairment is frequently observed, and pathophysiological complications often develop when the host response is modulated by the pathogen. The neutrophil heparin-binding protein (HBP) is an inflammatory mediator and potent inducer of vascular leakage. RESULTS In this study, we found that leptospires and their secreted products induce the release of HBP from stimulated neutrophils through a controlled degranulation mechanism. We acknowledged 2 leptospiral proteins as able to induce HBP degranulation. These findings have clinical implications, as high levels of HBP were detected in serum from patients with leptospirosis, especially at the early phase of the disease. CONCLUSION In conclusion, we describe a new mechanism by which the leptospirosis pathophysiological complications may arise, such as vascular leakage and edema formation. We also propose HBP as a new early screening biomarker for human leptospirosis.
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Affiliation(s)
- Mônica L Vieira
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden.,Laboratório Especial de Desenvolvimento de Vacinas
| | - Sandra Persson
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | | | - Karin Kirchgatter
- Nucleo de Estudos em Malária, Superintendência de Controle de Endemias, Instituto de Medicina Tropical de São Paulo, Universidade de São Paulo, São Paulo, Brazil
| | | | - Heiko Herwald
- Division of Infection Medicine, Department of Clinical Sciences, Lund University, Lund, Sweden
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Prevalence of Leptospira Infection in Rodents from Bangladesh. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16122113. [PMID: 31207905 PMCID: PMC6616592 DOI: 10.3390/ijerph16122113] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 06/08/2019] [Accepted: 06/11/2019] [Indexed: 12/27/2022]
Abstract
Worldwide, Leptospira infection poses an increasing public health problem. In 2008, leptospirosis was recognised as a re-emerging zoonosis of global importance with South-East Asia being one of the most significant centres of the disease. Rodents are thought to be the most important host for a variety of Leptospira serovars. Because Bangladesh offers a suitable humid climate for the survival of these pathogenic bacteria, the presence of rodents could be a serious risk for human infection, especially in peri-urban areas or locations where food is stored. In order to gain more understanding of the multi-host epidemiology, a prevalence study was conducted in Comilla, Bangladesh to determine the presence of pathogenic Leptospira species in rodents. Real-time Polymerase Chain Reaction (qPCR) and sequencing showed that 13.1% (61/465) of the trapped rodents were infected with pathogenic Leptospira. Sequencing of the qPCR products identified the presence of three species: Leptospira interrogans, Leptospira borgpetersenii, and Leptospira kirschneri. Rodents of the genus, Bandicota, were significantly more likely to be positive than those of the genus, Rattus and Mus. Our results confirm the importance of rodents as hosts of pathogenic Leptospira and indicate that human exposure to pathogenic Leptospira may be considerable, also in places where food (rice) is stored for longer times. This study emphasizes the need to improve rodent management at such locations and to further quantify the public health impacts of this neglected emerging zoonosis in Bangladesh.
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Markovych O, Tymchyk V, Kolesnikova I. Leptospirosis in Zakarpattia Oblast (2005-2015). Vector Borne Zoonotic Dis 2019; 19:333-340. [PMID: 30835637 PMCID: PMC6486664 DOI: 10.1089/vbz.2018.2356] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Background: Leptospirosis occurs sporadically and as outbreaks throughout Ukraine and is a nationally reportable disease. Zakarpattia oblast, in the southwestern region of the country, is endemic for disease. This study examines changes in epidemic patterns from 2005 to 2015. Materials and Methods: Suspected cases from health care services were identified based on clinical presentation and serological samples were collected. Patient sera were tested by microscopic agglutination test (MAT) against serovars of Leptospira spp. belonging to 13 serogroups. Small mammals were also collected, sampled, and tested near locations of suspected exposures. Changes in leptospirosis incidence in Zakarpattia oblast were characterized over an 11-year period. Results: A total of 420/2079 possible human cases were identified as having leptospirosis and 401/420 were confirmed by MAT. There was no annual trend in prevalence. Incidence increased from 2005 to 2009, peaked in 2010 (6.24 cases/100,000), and by 2015, there were only sporadic cases (0.88/100,000). The predominant serogroups were Icterohaemorrhagiae, Hebdomadis, and Grippotyphosa of Leptospira spp. The dominant serogroups shifted during the study from predominantly Icterohaemorrhagiae to Grippotyphosa in later years. A total of 2820 small mammals were assayed for Leptospira spp. Apodemus agrarius, Rattus norvegicus, and Mus musculus were the most common species sampled (76.1% of all captures). Among small mammals, antibodies were found mostly for Icterohaemorrhagiae, Pomona, and Grippotyphosa serogroups, and were detected in 276 samples (9.79% ± 0.56%). The dominant serogroups of Leptospira spp. isolated from mammals and patients changed cyclically, but the common human serogroups tended to differ from that seen in the concurrent mammal populations. Conclusions: Patients with leptospirosis in this endemic region decreased more than fivefold during the past decade. Leptospira infections in small mammals remained common across multiple species ranging from 5% to 14%.
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Affiliation(s)
- Olga Markovych
- 1 Laboratory of Especially Dangerous Infections, Department of Biological Factors Studies, Zakarpattia Oblast Laboratory Center of the Ministry of Health of Ukraine, Uzhhorod, Ukraine
| | - Victoria Tymchyk
- 2 Department of Epidemiological Surveillance and Prevention of Infectious Diseases, Zakarpattia Oblast Laboratory Center of the Ministry of Health of Ukraine, Uzhhorod, Ukraine
| | - Iryna Kolesnikova
- 3 Epidemiology Department, Bogomolets National Medical University, Kyiv, Ukraine
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Smith S, Kennedy BJ, Dermedgoglou A, Poulgrain SS, Paavola MP, Minto TL, Luc M, Liu YH, Hanson J. A simple score to predict severe leptospirosis. PLoS Negl Trop Dis 2019; 13:e0007205. [PMID: 30759081 PMCID: PMC6391019 DOI: 10.1371/journal.pntd.0007205] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2018] [Revised: 02/26/2019] [Accepted: 01/30/2019] [Indexed: 02/01/2023] Open
Abstract
Background The case-fatality rate of severe leptospirosis can exceed 50%. While prompt supportive care can improve survival, predicting those at risk of developing severe disease is challenging, particularly in settings with limited diagnostic support. Methodology/Principal findings We retrospectively identified all adults with laboratory-confirmed leptospirosis in Far North Queensland, Australia, between January 1998 and May 2016. Clinical, laboratory and radiological findings at presentation were correlated with the patients’ subsequent clinical course. Medical records were available in 402 patients; 50 (12%) had severe disease. The presence of oliguria (urine output ≤500 mL/24 hours, odds ratio (OR): 16.4, 95% confidence interval (CI): 6.9–38.8, p<0.001), abnormal auscultatory findings on respiratory examination (OR 11.2 (95% CI: 4.7–26.5, p<0.001) and hypotension (systolic blood pressure ≤100 mmHg, OR 4.3 (95% CI 1.7–10.7, p = 0.002) at presentation independently predicted severe disease. A three-point score (the SPiRO score) was devised using these three clinical variables, with one point awarded for each. A score could be calculated in 392 (98%) patients; the likelihood of severe disease rose incrementally: 8/287 (3%), 14/70 (20%), 18/26 (69%) and 9/9 (100%) for a score of 0, 1, 2 and 3 respectively (p = 0.0001). A SPiRO score <1 had a negative predictive value for severe disease of 97% (95% CI: 95–99%). Conclusions/Significance A simple, three-point clinical score can help clinicians rapidly identify patients at risk of developing severe leptospirosis, prompting early transfer to referral centres for advanced supportive care. This inexpensive, bedside assessment requires minimal training and may have significant utility in the resource-limited settings which bear the greatest burden of disease. Leptospirosis, a neglected tropical disease with a global distribution, is estimated to kill 60,000 people every year. Predicting those at risk of developing severe disease is challenging, and a simple scoring system to quantify the risk of severe disease has proven elusive. Identifying the high-risk patient is important, as it might expedite the initiation of life-saving supportive care. This review of 402 adult patients with leptospirosis in tropical Australia determined that three clinical variables identified at presentation independently predicted severe disease (a subsequent requirement for Intensive Care Unit admission, intubation, vasopressor support, renal replacement therapy or the development of pulmonary haemorrhage). These three variables (abnormal auscultatory findings on respiratory examination, hypotension and oliguria) were used to generate a simple, three-point clinical score which can be determined rapidly and reliably at the bedside by health care workers with minimal training. This simple score may help the clinical management of patients with leptospirosis, particularly in lower and middle-income countries that bear the greatest burden of disease.
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Affiliation(s)
- Simon Smith
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
- James Cook University, Cairns Campus, Cairns, Queensland, Australia
| | - Brendan J. Kennedy
- Infectious Diseases Service, Royal Adelaide Hospital, Adelaide, South Australia, Australia
- Communicable Disease Control Branch, Adelaide, South Australia, Australia
| | | | | | | | - Tarryn L. Minto
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Michael Luc
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
| | - Yu-Hsuan Liu
- Department of Intensive Care, Cairns Hospital, Cairns, Queensland, Australia
| | - Josh Hanson
- Department of Medicine, Cairns Hospital, Cairns, Queensland, Australia
- The Kirby Institute, University of New South Wales, Sydney, Australia
- * E-mail:
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Kumar S, Lata KS, Sharma P, Bhairappanavar SB, Soni S, Das J. Inferring pathogen-host interactions between Leptospira interrogans and Homo sapiens using network theory. Sci Rep 2019; 9:1434. [PMID: 30723266 PMCID: PMC6363727 DOI: 10.1038/s41598-018-38329-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Accepted: 12/20/2018] [Indexed: 12/19/2022] Open
Abstract
Leptospirosis is the most emerging zoonotic disease of epidemic potential caused by pathogenic species of Leptospira. The bacterium invades the host system and causes the disease by interacting with the host proteins. Analyzing these pathogen-host protein interactions (PHPIs) may provide deeper insight into the disease pathogenesis. For this analysis, inter-species as well as intra-species protein interactions networks of Leptospira interrogans and human were constructed and investigated. The topological analyses of these networks showed lesser connectivity in inter-species network than intra-species, indicating the perturbed nature of the inter-species network. Hence, it can be one of the reasons behind the disease development. A total of 35 out of 586 PHPIs were identified as key interactions based on their sub-cellular localization. Two outer membrane proteins (GpsA and MetXA) and two periplasmic proteins (Flab and GlyA) participating in PHPIs were found conserved in all pathogenic, intermediate and saprophytic spp. of Leptospira. Furthermore, the bacterial membrane proteins involved in PHPIs were found playing major roles in disruption of the immune systems and metabolic processes within host and thereby causing infectious disease. Thus, the present results signify that the membrane proteins participating in such interactions hold potential to serve as effective immunotherapeutic candidates for vaccine development.
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Affiliation(s)
- Swapnil Kumar
- Gujarat Biotechnology Research Centre, Department of Science & Technology, Government of Gujarat, Gandhinagar, 382011, India
| | - Kumari Snehkant Lata
- Gujarat Biotechnology Research Centre, Department of Science & Technology, Government of Gujarat, Gandhinagar, 382011, India
| | - Priyanka Sharma
- Gujarat Biotechnology Research Centre, Department of Science & Technology, Government of Gujarat, Gandhinagar, 382011, India
| | - Shivarudrappa B Bhairappanavar
- Gujarat Biotechnology Research Centre, Department of Science & Technology, Government of Gujarat, Gandhinagar, 382011, India
| | - Subhash Soni
- Gujarat Biotechnology Research Centre, Department of Science & Technology, Government of Gujarat, Gandhinagar, 382011, India
| | - Jayashankar Das
- Gujarat Biotechnology Research Centre, Department of Science & Technology, Government of Gujarat, Gandhinagar, 382011, India.
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18
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Li S, Liu Y, Chen X, Wang M, Hu W, Yan J. Visual and Rapid Detection of Leptospira interrogans Using Multiple Cross-Displacement Amplification Coupled with Nanoparticle-Based Lateral Flow Biosensor. Vector Borne Zoonotic Dis 2019; 19:604-612. [PMID: 30702382 DOI: 10.1089/vbz.2018.2395] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Leptospirosis is a worldwide zoonosis caused by spirochetes from the genus Leptospira. In the present study, a visual and rapid method for detecting Leptospira interrogans was developed based on multiple cross-displacement amplification (MCDA) and nanoparticle-based lateral flow biosensor (LFB). A set of 10 primers was specifically designed to recognize 10 regions of the lipL 41 gene of L. interrogans. The MCDA reaction was optimized at 64°C for only 40 min, and the amplification products were directly applied to the biosensor. The entire process, including DNA extraction (25 min), MCDA reaction (40 min), and result interpretation (∼2 min), could be completed within 70 min. Amplification products were detectable from as few as 10 genomic equivalents per reaction of pure L. interrogans DNA. No cross-reaction with nonpathogenic Leptospira or other bacteria was observed. The MCDA-LFB method established in the current report is suitable for the rapid screening of L. interrogans in clinical, animal, and environmental samples.
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Affiliation(s)
- Shijun Li
- 1Guizhou Provincial Centre for Disease Control and Prevention, Guiyang, China
| | - Ying Liu
- 1Guizhou Provincial Centre for Disease Control and Prevention, Guiyang, China
| | - Xu Chen
- 1Guizhou Provincial Centre for Disease Control and Prevention, Guiyang, China
| | - Ming Wang
- 1Guizhou Provincial Centre for Disease Control and Prevention, Guiyang, China
| | - Weilin Hu
- 2Department of Medical Microbiology and Parasitology, College of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Yan
- 2Department of Medical Microbiology and Parasitology, College of Medicine, Zhejiang University, Hangzhou, China
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19
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Validi M, Karkhah A, Prajapati VK, Nouri HR. Immuno-informatics based approaches to design a novel multi epitope-based vaccine for immune response reinforcement against Leptospirosis. Mol Immunol 2018; 104:128-138. [PMID: 30448609 DOI: 10.1016/j.molimm.2018.11.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 09/04/2018] [Accepted: 11/08/2018] [Indexed: 01/03/2023]
Abstract
Leptospirosis is known as a zoonotic disease of global importance originated from infection with the spirochete bacterium Leptospira. Although several leptospirosis vaccines have been tested, the vaccination is relatively unsuccessful in clinical application despite decades of research. Therefore, this study was conducted to construct a novel multi-epitope based vaccine against leptospirosis by using Hap1, LigA, LAg42, SphH and HSP58 antigens. T cell and IFN gamma epitopes were predicted from these antigens. In addition, to induce strong CD4+ helper T lymphocytes (HTLs) responses, Pan HLA DR-binding epitope (PADRE) and helper epitopes selected from Tetanus toxin fragment C (TTFrC) were applied. Moreover, for boosting immune response, Heparin-Binding Hemagglutinin (HBHA), a novel TLR4 agonist was added to the construct as an adjuvant. Finally, selected epitopes were linked together using EAAAK, GPGPG, AAY and HEYGAEALERAG linkers. Based on the predicted epitopes, a multi-epitope vaccine was construct with 490 amino acids. Physico-chemical properties, secondary and tertiary structures, stability, intrinsic protein disorder, solubility, and allergenicity of this vaccine construct were assessed by applying immunoinformatics analyses. A soluble, and non-allergic protein with a molecular weight of 53.476 kDa was obtained. Further analyses validated the stability of the chimeric protein and the predicted epitopes in the chimeric vaccine indicated strong potential to induce B-cell and T-cell mediated immune response. Therefore, immunoinformatics analysis showed that the modeled multi-epitope vaccine can properly stimulate the both T and B cells immune responses and could potentially be used for prophylactic or therapeutic usages.
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Affiliation(s)
- Majid Validi
- Clinical Biochemistry Research Center, Basic Health Sciences Institute, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Ahmad Karkhah
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran; Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran
| | - Vijay Kumar Prajapati
- Department of Biochemistry, School of Life Sciences, Central University of Rajasthan, Bandarsindri, Kishangarh, Ajmer, Rajasthan, India
| | - Hamid Reza Nouri
- Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
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20
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Vieira ML, Teixeira AF, Pidde G, Ching ATC, Tambourgi DV, Nascimento ALTO, Herwald H. Leptospira interrogans outer membrane protein LipL21 is a potent inhibitor of neutrophil myeloperoxidase. Virulence 2018; 9:414-425. [PMID: 29235397 PMCID: PMC5955187 DOI: 10.1080/21505594.2017.1407484] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
Leptospirosis is a widespread zoonotic and neglected infectious disease of human and veterinary concern that is caused by pathogenic Leptospira species. After entrance in the host, pathogenic leptospires evade the host natural defense mechanisms in order to propagate and disseminate to multiple organs. Myeloperoxidase is an enzyme stored in neutrophils azurophilic granules, and is released upon neutrophil activation to produce mainly hypochlorous acid, a strong oxidant and potent antimicrobial agent. In the present investigation, we studied the modulation of myeloperoxidase activity by L. interrogans serovar Copenhageni. We show that leptospires and their culture supernatants are able to inhibit both peroxidase and chlorination activities of myeloperoxidase, without interfering with neutrophil degranulation. By leptospiral outer membrane protein extraction and fractionation, we identified the proteins LipL21 and LipL45 as myeloperoxidase inhibitors, constituting new Leptospira virulence factors. Accordingly, we propose a function for the protein LipL21, one of the most expressed leptospiral outer membrane proteins. Our results show a novel innate immune evasion mechanism by which leptospires interfere with the host response in order to cope with the host oxidative stress and efficiently achieve dissemination and colonization.
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Affiliation(s)
- Monica L Vieira
- a Department of Clinical Sciences, Lund, Division of Infection Medicine , Lund University , Lund , Sweden.,b Centro de Biotecnologia, Instituto Butantan , Avenida Vital Brazil, São Paulo , SP , Brazil
| | - Aline F Teixeira
- b Centro de Biotecnologia, Instituto Butantan , Avenida Vital Brazil, São Paulo , SP , Brazil
| | - Giselle Pidde
- c Laboratório de Imunoquímica, Instituto Butantan , Avenida Vital Brazil, São Paulo , SP , Brazil
| | - Ana T C Ching
- c Laboratório de Imunoquímica, Instituto Butantan , Avenida Vital Brazil, São Paulo , SP , Brazil
| | - Denise V Tambourgi
- c Laboratório de Imunoquímica, Instituto Butantan , Avenida Vital Brazil, São Paulo , SP , Brazil
| | | | - Heiko Herwald
- a Department of Clinical Sciences, Lund, Division of Infection Medicine , Lund University , Lund , Sweden
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Gurumurthy K, Narasimha HB, Wyawahare M, Biswal N. Leptospirosis: a diagnostic conundrum. Trop Doct 2018; 48:306-309. [PMID: 30124128 DOI: 10.1177/0049475518788470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leptospirosis is a serious public health concern worldwide. It is highly endemic in the Andaman Islands and its prevalence is increasing in other Indian states. Clinical features are non-specific and diagnosis relies on laboratory confirmation. The gold standard is microscopic agglutination testing, but this is not widely available. Real-time polymerase chain reaction testing of LipL32 antigen provides the earliest detection of pathogenic Leptospira in the body. We found it to be 100% specific, but it should be used in the first 10 days of illness for reliable results.
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Affiliation(s)
- Keerthivasan Gurumurthy
- 1 Assistant Professor, Department of Microbiology, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India
| | - Harish Belgode Narasimha
- 2 Senior Professor, Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Mukta Wyawahare
- 3 Associate Professor, Department of General Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
| | - Niranjan Biswal
- 4 Professor, Department of Paediatrics, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Dhewantara PW, Mamun AA, Zhang WY, Yin WW, Ding F, Guo D, Hu W, Costa F, Ko AI, Soares Magalhães RJ. Epidemiological shift and geographical heterogeneity in the burden of leptospirosis in China. Infect Dis Poverty 2018; 7:57. [PMID: 29866175 PMCID: PMC5985562 DOI: 10.1186/s40249-018-0435-2] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 04/27/2018] [Indexed: 01/16/2023] Open
Abstract
Background Leptospirosis morbidity and mortality rates in China have decreased since the 2000s. Further analyses of the spatiotemporal and demographic changes occurring in the last decade and its implication on estimates of disease burden are required to inform intervention strategies. In this study, we quantified the epidemiological shift and geographical heterogeneity in the burden of leptospirosis during 2005–2015 in China. Methods We used reported leptospirosis case data from 1st January 2005 to 31st of December 2015 that routinely collected by the China Information System for Disease Control and Prevention (CISDCP) to analyze the epidemiological trend and estimate the burden in terms of disability-adjusted life-years (DALYs) over space, time, and demographical groups. Results A total of 7763 cases were reported during 2005–2015. Of which, 2403 (31%) cases were the laboratory-confirmed case. Since 2005, the notified incidence rate was gradually decreased (P < 0.05) and it was relatively stable during 2011–2015 (P > 0.05). During 2005–2015, we estimated a total of 10 313 DALYs were lost due to leptospirosis comprising a total of 1804 years-lived with disability (YLDs) and 8509 years-life lost (YLLs). Males had the highest burden of disease (7149 DALYs) compared to females (3164 DALYs). The highest burden estimate was attributed to younger individuals aged 10–19 years who lived in southern provinces of China. During 2005–2015, this age group contributed to approximately 3078 DALYs corresponding to 30% of the total DALYs lost in China. Yet, our analysis indicated a declining trend in burden estimates (P < 0.001) since 2005 and remained relatively low during 2011–2015. Low burden estimates have been identified in the endemic regions where infections principally distributed. Most of the changes in DALY estimates were driven by changes in YLLs. Conclusions In the last 11-years, the burden estimates of leptospirosis have shown a declining trend across the country; however, leptospirosis should not be neglected as it remains an important zoonotic disease and potentially affecting the young and productive population in economically less-developed provinces in southern of China. In addition, while in the last five years the incidence has been reported at very low-level, this might not reflect the true incidence of leptospirosis. Strengthened surveillance in the endemic regions is, hence, substantially required to capture the actual prevalence to better control leptospirosis in China. Electronic supplementary material The online version of this article (10.1186/s40249-018-0435-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pandji Wibawa Dhewantara
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia. .,National Institute of Health Research and Development (NIHRD), Ministry of Health of Indonesia, Unit of Vector-borne Diseases Control, Pangandaran, West Java, 46396, Indonesia.
| | - Abdullah A Mamun
- Institute for Social Science Research, The University of Queensland, Indooroopilly, QLD, 4068, Australia
| | - Wen-Yi Zhang
- Center for Disease Surveillance and Research, Institute of Disease Control and Prevention of PLA, Beijing, 100071, People's Republic of China.
| | - Wen-Wu Yin
- Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Fan Ding
- Chinese Center for Disease Control and Prevention, Beijing, 102206, People's Republic of China
| | - Danhuai Guo
- Scientific Data Center, Computer Network Information Center, Chinese Academy of Sciences, Beijing, 100190, People's Republic of China
| | - Wenbiao Hu
- School of Public Health and Social Work, Queensland University of Technology, Kelvin Grove, QLD, 4059, Australia
| | - Federico Costa
- Instituto Gonçalo Moniz, Fundação Oswaldo Cruz, Ministério da Saúde, Salvador, BA, 40296-710, Brazil.,Instituto da Saúde Coletiva, Federal University of Bahia (UFBA), Salvador, BA, 40110-040, Brazil.,Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06520, USA
| | - Albert Icksang Ko
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, CT, 06520, USA
| | - Ricardo J Soares Magalhães
- Spatial Epidemiology Laboratory, School of Veterinary Science, The University of Queensland, Gatton, QLD, 4343, Australia.,Children's Health and Environment Program, Child Health Research Centre, The University of Queensland, South Brisbane, QLD, 4101, Australia
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Abstract
There have been repeated outbreaks of leptospirosis reported all over the world. Being one of the largest cities in the world, Hong Kong is no exception. We report a local case involved in an outbreak of the disease with a typical route of acquisition but rare complications. A brief account on the epidemiology of both Hong Kong and Southern China is given. Discussions on the pathophysiology of the disease and its complications are also presented.
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Jiménez JIS, Marroquin JLH, Richards GA, Amin P. Leptospirosis: Report from the task force on tropical diseases by the World Federation of Societies of Intensive and Critical Care Medicine. J Crit Care 2017; 43:361-365. [PMID: 29129539 DOI: 10.1016/j.jcrc.2017.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2017] [Accepted: 11/01/2017] [Indexed: 12/26/2022]
Abstract
Leptospirosis is a zoonosis caused by a gram negative aerobic spirochete of the genus Leptospira. It is acquired by contact with urine or reproductive fluids from infected animals, or by inoculation from contaminated water or soil. The disease has a global distribution, mainly in tropical and subtropical regions that have a humid, rainy climate and is also common in travelers returning from these regions. Clinical suspicion is critical for the diagnosis and it should be included in the differential diagnosis of any patient with a febrile hepatorenal syndrome in, or returning from endemic regions. The leptospiremic phase occurs early and thereafter there is an immunologic phase in which the most severe form, Weil's disease, occurs. In the latter, multiple organ dysfunction predominates. The appropriate diagnostic test depends on the stage of the disease and consists of direct and indirect detection methods and cultures. Severely ill patients need to be monitored in an ICU with appropriate anti-bacterial agents and early, aggressive and effective organ support. Antibiotic therapy consists of penicillins, macrolides or third generation cephalosporins.
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Affiliation(s)
- Juan Ignacio Silesky Jiménez
- Head of Critical Care Unit, Hospital San Juan de Dios and Hospital CIMA, San José, Costa Rica. Postgraduate Council Member of Critical Care, Universidad de Costa Rica, Costa Rica
| | - Jorge Luis Hidalgo Marroquin
- Division of Critical Care, Karl Heusner Memorial Hospital/Belize Healthcare Partners Belize Central America, Belize
| | - Guy A Richards
- Division of Critical Care, Charlotte Maxeke Hospital and Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
| | - Pravin Amin
- Department of Critical Care Medicine, Bombay Hospital Institute of Medical Sciences, Mumbai, India
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25
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Escandón-Vargas K, Osorio L, Astudillo-Hernández M. Seroprevalence and factors associated with Leptospira infection in an urban district of Cali, Colombia. CAD SAUDE PUBLICA 2017; 33:e00039216. [PMID: 28614448 DOI: 10.1590/0102-311x00039216] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Accepted: 07/13/2016] [Indexed: 12/23/2022] Open
Abstract
Few studies have addressed Leptospira seroprevalence and risk factors in urban populations in Colombia. This study aimed to determine seroprevalence and factors associated with Leptospira infection in inhabitants of an urban district of Cali, Colombia. We collected sociodemographic and environmental data, as well as blood samples, from 353 subjects selected through a multistage cluster sampling design. We performed microagglutination test for the eight main Leptospira serogroups circulating in the region, considering a cut-off titer of ≥ 1:100. Most participants were female (226, 64.8%), with mean age 41.4 years, and 89 (32.6%) lived in low-low socioeconomic stratum (SES-1). Overall seroprevalence was 12.2% (95%CI: 10.3%-14.4%). Factors associated with Leptospira infection were SES 1, older age, single marital status, ethnic groups (Afro-Colombian and white/mestizo), school students, absence of toilet, barefoot walking, travel outside Cali in the previous month, and absence of skin and mucous-membrane lesions in the previous month. Our study suggests domestic and peridomiciliary transmission of Leptospira likely related to activities of daily living and inadequate environmental conditions. SES-1 is a major factor associated with Leptospira infection (adjusted OR = 4.08; 95%CI: 2.54-6.53; p < 0.001), suggesting that social and environmental conditions are key elements for endemicity of Leptospira infection in the study area. Epidemiological surveillance, improvement of environmental and sanitary conditions in various SES-1 areas, and community educational campaigns are recommended.
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Affiliation(s)
- Kevin Escandón-Vargas
- Escuela de Medicina, Facultad de Salud, Universidad del Valle, Cali, Colombia.,Escuela de Ciencias Básicas, Facultad de Salud, Universidad del Valle, Cali, Colombia
| | - Lyda Osorio
- Escuela de Salud Pública, Facultad de Salud, Universidad del Valle, Cali, Colombia
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26
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da Costa Vasconcelos FN, Maciel NK, Favaro DC, de Oliveira LC, Barbosa AS, Salinas RK, de Souza RF, Farah CS, Guzzo CR. Structural and Enzymatic Characterization of a cAMP-Dependent Diguanylate Cyclase from Pathogenic Leptospira Species. J Mol Biol 2017; 429:2337-2352. [PMID: 28601495 DOI: 10.1016/j.jmb.2017.06.002] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Revised: 06/01/2017] [Accepted: 06/01/2017] [Indexed: 12/23/2022]
Abstract
Leptospira interrogans serovar Copenhageni is a human pathogen that causes leptospirosis, a worldwide zoonosis. The L. interrogans genome codes for a wide array of potential diguanylate cyclase (DGC) enzymes with characteristic GGDEF domains capable of synthesizing the cyclic dinucleotide c-di-GMP, known to regulate transitions between different cellular behavioral states in bacteria. Among such enzymes, LIC13137 (Lcd1), which has an N-terminal cGMP-specific phosphodiesterases, adenylyl cyclases, and FhlA (GAF) domain and a C-terminal GGDEF domain, is notable for having close orthologs present only in pathogenic Leptospira species. Although the function and structure of GGDEF and GAF domains have been studied extensively separately, little is known about enzymes with the GAF-GGDEF architecture. In this report, we address the question of how the GAF domain regulates the DGC activity of Lcd1. The full-length Lcd1 and its GAF domain form dimers in solution. The GAF domain binds specifically cAMP (KD of 0.24μM) and has an important role in the regulation of the DGC activity of the GGDEF domain. Lcd1 DGC activity is negligible in the absence of cAMP and is significantly enhanced in its presence (specific activity of 0.13s-1). The crystal structure of the Lcd1 GAF domain in complex with cAMP provides valuable insights toward explaining its specificity for cAMP and pointing to possible mechanisms by which this cyclic nucleotide regulates the assembly of an active DGC enzyme.
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Affiliation(s)
| | - Nikolas Koshiyama Maciel
- Departamento de Microbiologia, Instituto de Ciências Biomedicas, Universidade de São Paulo, São Paulo, 05508-900, Brazil
| | - Denize Cristina Favaro
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, 05508-900, Brazil; Departamento de Química, Instituto de Ciências Exatas, Universidade Federal de Minas Gerais, Belo Horizonte, 31270-901, Brazil
| | | | | | - Roberto Kopke Salinas
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, 05508-900, Brazil
| | - Robson Francisco de Souza
- Departamento de Microbiologia, Instituto de Ciências Biomedicas, Universidade de São Paulo, São Paulo, 05508-900, Brazil
| | - Chuck Shaker Farah
- Departamento de Bioquímica, Instituto de Química, Universidade de São Paulo, São Paulo, 05508-900, Brazil
| | - Cristiane Rodrigues Guzzo
- Departamento de Microbiologia, Instituto de Ciências Biomedicas, Universidade de São Paulo, São Paulo, 05508-900, Brazil.
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27
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Vieira ML, de Andrade SA, Morais ZM, Vasconcellos SA, Dagli MLZ, Nascimento ALTO. Leptospira Infection Interferes with the Prothrombinase Complex Assembly during Experimental Leptospirosis. Front Microbiol 2017; 8:500. [PMID: 28400758 PMCID: PMC5368274 DOI: 10.3389/fmicb.2017.00500] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2016] [Accepted: 03/10/2017] [Indexed: 01/18/2023] Open
Abstract
Leptospirosis is a worldwide zoonotic and neglected infectious disease of human and veterinary concern, caused by pathogenic Leptospira species. Although bleeding is a common symptom of severe leptospirosis, the cause of hemorrhage is not completely understood. In severe infections, modulation of hemostasis by pathogens is an important virulence mechanism, and hemostatic impairments such as coagulation/fibrinolysis dysfunction are frequently observed. Here, we analyze the coagulation status of experimentally infected hamsters in an attempt to determine coagulation interferences and the origin of leptospirosis hemorrhagic symptomatology. Hamsters were experimentally infected with L. interrogans. The lungs, kidneys, and livers were collected for culture, histopathology, and coagulation assays. L. interrogans infection disturbs normal coagulation in the organs of animals. Our results suggest the presence of a thrombin-like factor or FX activator, which is able to activate FII in the leptospirosis organ extracts. The activity of those factors is accelerated in the prothrombinase complex. Additionally, we show for the first time that live leptospires act as a surface for the prothrombinase complex assembly. Our results contribute to the understanding of leptospirosis pathophysiological mechanisms and may open new routes for the discovery of novel treatments in the severe manifestations of the disease.
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Affiliation(s)
- Monica L Vieira
- Laboratorio Especial de Desenvolvimento de Vacinas, Instituto Butantan São Paulo, Brazil
| | - Sonia A de Andrade
- Laboratório de Síntese Orgânica - Laboratório Especial de Toxinologia Aplicada São Paulo, Brazil
| | - Zenaide M Morais
- Laboratório de Zoonoses Bacterianas, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo São Paulo, Brazil
| | - Silvio A Vasconcellos
- Laboratório de Zoonoses Bacterianas, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo São Paulo, Brazil
| | - Maria Lucia Z Dagli
- Departmento de Patologia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo São Paulo, Brazil
| | - Ana Lucia T O Nascimento
- Laboratorio Especial de Desenvolvimento de Vacinas, Instituto ButantanSão Paulo, Brazil; Programa de Pós-Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, Universidade de São PauloSão Paulo, Brazil
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28
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Gomes DO, Ramos GB, Alves VBA, Ciuffa AZ, Cuccato LP, Dos Reis TFM, Lima AMC, Gonçalves MC, Tolesano GV, Rodrigues VS, Szabó MPJ. Occurrence of anti-Leptospira spp. antibodies in Rhipidomys spp. from a forest fragment of the Brazilian Cerrado. Trop Anim Health Prod 2017; 49:555-559. [PMID: 28124730 DOI: 10.1007/s11250-017-1227-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2016] [Accepted: 01/18/2017] [Indexed: 10/20/2022]
Abstract
Leptospirosis is a zoonotic disease of world importance, and its transmission depends on the interaction between humans and animals. Given the necessity to investigate potential hosts of Leptospira spp., this study verified the prevalence of different serovars in the species of Rhipidomys spp., a widespread sigmodont rodent in Brazil. The studied population originates from a semi-evergreen forest located in the county of Uberlândia, in the state of Minas Gerais. The microscopic agglutination test (MAT) was performed with 14 serovars. Thirteen out of the 43 wild rodents captured showed a positive agglutination reaction, with a greater prevalence of the serovars Pyrogenes, Copenhageni, and Canicola. This study found a prevalence of 30.3% anti-Leptospira spp. antibodies; all positive animals were reactive to more than one serovar.
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Affiliation(s)
- D O Gomes
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil.
| | - G B Ramos
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - V B A Alves
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - A Z Ciuffa
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - L P Cuccato
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - T F M Dos Reis
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - A M C Lima
- Laboratório de Doenças Infectocontagiosas, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - M C Gonçalves
- Laboratório de Ixodologia, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - G V Tolesano
- Laboratório de Ixodologia, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - V S Rodrigues
- Laboratório de Ixodologia, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
| | - M P J Szabó
- Laboratório de Ixodologia, Faculdade de Medicina Veterinária of the Universidade Federal de Uberlândia, Rua Ceará, Bloco 2D, Segundo andar, Sala 33, 38.405-315, Uberlândia, State of Minas Gerais, Brazil
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29
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Vieira ML, Naudin C, Mörgelin M, Romero EC, Nascimento ALTO, Herwald H. Modulation of Hemostatic and Inflammatory Responses by Leptospira Spp. PLoS Negl Trop Dis 2016; 10:e0004713. [PMID: 27167223 PMCID: PMC4864083 DOI: 10.1371/journal.pntd.0004713] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 04/24/2016] [Indexed: 12/28/2022] Open
Abstract
Leptospirosis is a worldwide spread zoonotic and neglected infectious disease of human and veterinary concern that is caused by pathogenic Leptospira species. In severe infections, hemostatic impairments such as coagulation/fibrinolysis dysfunction are frequently observed. These complications often occur when the host response is controlled and/or modulated by the bacterial pathogen. In the present investigation, we aimed to analyze the modulation of the hemostatic and inflammatory host responses by the bacterial pathogen Leptospira. The effects of leptospires and their secreted products on stimulation of human intrinsic and extrinsic pathways of coagulation were investigated by means of altered clotting times, assembly and activation of contact system and induction of tissue factor. We show that both extrinsic and intrinsic coagulation cascades are modulated in response to Leptospira or leptospiral secreted proteins. We further find that the pro-inflammatory mediator bradykinin is released following contact activation at the bacterial surface and that pro-coagulant microvesicles are shed from monocytes in response to infection. Also, we show that human leptospirosis patients present higher levels of circulating pro-coagulant microvesicles than healthy individuals. Here we show that both pathways of the coagulation system are modulated by leptospires, possibly leading to altered hemostatic and inflammatory responses during the disease. Our results contribute to the understanding of the leptospirosis pathophysiological mechanisms and may open new routes for the discovery of novel treatments for the severe manifestations of the disease. Leptospirosis is one of the most relevant and spread zoonotic and neglected infectious diseases affecting humans and other mammals, and is caused by pathogenic bacteria of the genus Leptospira. During infectious diseases, when bacterial pathogens control and/or modulate the host response, impaired hemostasis and inflammation are frequently observed. Here we studied the effects of leptospires and their secreted products on stimulation of human intrinsic and extrinsic pathways of coagulation, showing that both coagulation cascades are modulated in response to Leptospira or leptospiral secreted proteins. We further find that activation of the coagulation cascades culminates in the release of the pro-inflammatory mediator bradykinin and noted an induction of pro-coagulant microvesicles. These findings contribute to a better understanding of the local and systemic hemostastic complications during leptospirosis. Collectively, our results show how leptospires can affect host responses, possibly leading to altered host responses during the disease and giving rise to the leptospirosis symptomatology.
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Affiliation(s)
- Mônica L. Vieira
- Department of Clinical Sciences, Lund, Division of Infection Medicine, Lund University, Lund, Sweden
- Centro de Biotecnologia, Instituto Butantan, Sao Paulo, Sao Paulo, Brazil
- * E-mail: ; (MLV); (HH)
| | - Clément Naudin
- Department of Clinical Sciences, Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Matthias Mörgelin
- Department of Clinical Sciences, Lund, Division of Infection Medicine, Lund University, Lund, Sweden
| | - Eliete C. Romero
- Centro de Bacteriologia, Instituto Adolfo Lutz, Sao Paulo, Sao Paulo, Brazil
| | | | - Heiko Herwald
- Department of Clinical Sciences, Lund, Division of Infection Medicine, Lund University, Lund, Sweden
- * E-mail: ; (MLV); (HH)
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31
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Fernandes LG, Siqueira GH, Teixeira ARF, Silva LP, Figueredo JM, Cosate MR, Vieira ML, Nascimento ALTO. Leptospira spp.: Novel insights into host-pathogen interactions. Vet Immunol Immunopathol 2015; 176:50-7. [PMID: 26727033 DOI: 10.1016/j.vetimm.2015.12.004] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2015] [Revised: 12/09/2015] [Accepted: 12/10/2015] [Indexed: 01/30/2023]
Abstract
Leptospirosis is a widespread zoonosis caused by pathogenic Leptospira spp. It is an important infectious disease that affects humans and animals. The disease causes economic losses as it affects livestock, with decreased milk production and death. Our group is investigating the genome sequences of L. interrogans targeting surface-exposed proteins because, due to their location, these proteins are capable to interact with several host components that could allow establishment of the infection. These interactions may involve adhesion of the bacteria to extracellular matrix (ECM) components and, hence, help bacterial colonization. The bacteria could also react with the host fibrinolytic system and/or with the coagulation cascade components, such as, plasminogen (PLG) and fibrinogen (Fg), respectively. The binding with the first system generates plasmin (PLA), increasing the proteolytic power of the bacteria, while the second interferes with clotting in a thrombin-catalyzed reaction, which may promote hemorrhage foci and increase bacterial dissemination. Interaction with the complement system negative regulators may help bacteria to evade the host immune system, facilitating the invasion. This work compiles the main described leptospiral proteins that could act as adhesins, as PLG and fibrinogen receptors and as complement regulator binding proteins. We present models in which we suggest possible mechanisms of how leptospires might colonize and invade host tissues, causing the disease. Understanding leptospiral pathogenesis will help to identify antigen candidates that would contribute to the development of more effective vaccines and diagnostic tests.
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Affiliation(s)
- Luis G Fernandes
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil; Programa de Pós Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, USP, Avenida Prof. Lineu Prestes, 1730, 05508-900, São Paulo, SP, Brazil
| | - Gabriela H Siqueira
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil; Programa de Pós Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, USP, Avenida Prof. Lineu Prestes, 1730, 05508-900, São Paulo, SP, Brazil
| | - Aline R F Teixeira
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil; Programa de Pós Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, USP, Avenida Prof. Lineu Prestes, 1730, 05508-900, São Paulo, SP, Brazil
| | - Lucas P Silva
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil; Programa de Pós Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, USP, Avenida Prof. Lineu Prestes, 1730, 05508-900, São Paulo, SP, Brazil
| | - Jupciana M Figueredo
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil; Programa de Pós Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, USP, Avenida Prof. Lineu Prestes, 1730, 05508-900, São Paulo, SP, Brazil
| | - Maria R Cosate
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil
| | - Monica L Vieira
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil
| | - Ana L T O Nascimento
- Centro de Biotecnologia, Instituto Butantan, Avenida Vital Brazil, 1500, 05503-900, São Paulo, SP, Brazil; Programa de Pós Graduação Interunidades em Biotecnologia, Instituto de Ciências Biomédicas, USP, Avenida Prof. Lineu Prestes, 1730, 05508-900, São Paulo, SP, Brazil.
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Patra KP, Choudhury B, Matthias MM, Baga S, Bandyopadhya K, Vinetz JM. Comparative analysis of lipopolysaccharides of pathogenic and intermediately pathogenic Leptospira species. BMC Microbiol 2015; 15:244. [PMID: 26518696 PMCID: PMC4628369 DOI: 10.1186/s12866-015-0581-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2015] [Accepted: 10/23/2015] [Indexed: 12/31/2022] Open
Abstract
Background Lipopolysaccharides (LPS) are complex, amphipathic biomolecules that constitute the major surface component of Gram-negative bacteria. Leptospira, unlike other human-pathogenic spirochetes, produce LPS, which is fundamental to the taxonomy of the genus, involved in host-adaption and also the target of diagnostic antibodies. Despite its significance, little is known of Leptospira LPS composition and carbohydrate structure among different serovars. Results LPS from Leptospira interrogans serovar Copenhageni strain L1-130, a pathogenic species, and L. licerasiae serovar Varillal strain VAR 010, an intermediately pathogenic species, were studied. LPS prepared from aqueous and phenol phases were analyzed separately. L. interrogans serovar Copenhageni has additional sugars not found in L. licerasiae serovar Varillal, including fucose (2.7 %), a high amount of GlcNAc (12.3 %), and two different types of dideoxy HexNAc. SDS-PAGE indicated that L. interrogans serovar Copenhageni LPS had a far higher molecular weight and complexity than that of L. licerasiae serovar Varillal. Chemical composition showed that L. interrogans serovar Copenhageni LPS has an extended O-antigenic polysaccharide consisting of sugars, not present in L. licerasiae serovar Varillal. Arabinose, xylose, mannose, galactose and L-glycero-D-mannoheptose were detected in both the species. Fatty acid analysis by gas chromatography–mass spectrometry (GC-MS) showed the presence of hydroxypalmitate (3-OH-C16:0) only in L. interrogans serovar Copenhageni. Negative staining electron microscopic examination of LPS showed different filamentous morphologies in L. interrogans serovar Copenhageni vs. L. licerasiae serovar Varillal. Conclusions This comparative biochemical analysis of pathogenic and intermediately pathogenic Leptospira LPS reveals important carbohydrate and lipid differences that underlie future work in understanding the mechanisms of host-adaptation, pathogenicity and vaccine development in leptospirosis.
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Affiliation(s)
- Kailash P Patra
- Division of Infectious Diseases, Department of Medicine, Biomedical Research Facility, University of California San Diego, 9500 Gilman Drive, BRF 2, Room 5220, La Jolla, 92093-0760, California, USA.
| | - Biswa Choudhury
- Glycotechnology Core Resources, University of California San Diego, 9500 Gilman Drive, BRF 2, Room 4243, La Jolla, 92093-0687, California, USA.
| | - Michael M Matthias
- Division of Infectious Diseases, Department of Medicine, Biomedical Research Facility, University of California San Diego, 9500 Gilman Drive, BRF 2, Room 5220, La Jolla, 92093-0760, California, USA.
| | - Sheyenne Baga
- Division of Infectious Diseases, Department of Medicine, Biomedical Research Facility, University of California San Diego, 9500 Gilman Drive, BRF 2, Room 5220, La Jolla, 92093-0760, California, USA.
| | - Keya Bandyopadhya
- Glycotechnology Core Resources, University of California San Diego, 9500 Gilman Drive, BRF 2, Room 4243, La Jolla, 92093-0687, California, USA.
| | - Joseph M Vinetz
- Division of Infectious Diseases, Department of Medicine, Biomedical Research Facility, University of California San Diego, 9500 Gilman Drive, BRF 2, Room 5220, La Jolla, 92093-0760, California, USA.
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Daher EF, Vieira APF, Jacinto CN, Lima RSA, Girão MMV, Fernandes ATBM, Neto RJP, Silva GB. Differences among children, adolescents and adults with severe leptospirosis: A comparative analysis. Indian J Nephrol 2015; 24:166-70. [PMID: 25120294 PMCID: PMC4127836 DOI: 10.4103/0971-4065.132013] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Leptospirosis is a zoonosis of global importance caused by Leptospira interrogans. The aim of this study was to compare the data between children, adolescents and adults with leptospirosis. This is a retrospective study including a total of 373 consecutive patients with leptospirosis, admitted to tertiary hospitals in Northeast of Brazil, from May 1985 to August 2010. The patients were divided into two groups (age ≤21 years and >21 years). The adults were 304 (81.5%) of the population, with a mean ge of 41 ± 13 (range 22-84) years. The pediatric group was 16 ± 3 (range 9-21) years. Signs and symptoms where similar between the groups, excepting arrhythmia, which was more frequent in adults and vomiting, more common in children (16% vs. 0%, P = 0.04 and 65% vs. 79%, P = 0.02), respectively. Adult group presented with higher serum urea (137 vs. 97 mg/dl, P = 0.002) and creatinine (4.3 vs. 3.0 mg/dl, P = 0.007). Acute kidney injury (AKI) was observed in 80%, mainly in adults (83% vs. 70% P < 0.005). Adults required renal replacement therapy more frequently than children (38% vs. 11%, P < 0.0001). Mortality was higher in adults (14.8% vs. 2.8%, P = 0.005) and in adults with AKI (93% vs. 7%, P < 0.05). There are important differences between the adults and children with leptospirosis. AKI was more frequent in adults and it was associated with increased mortality.
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Affiliation(s)
- E F Daher
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - A P F Vieira
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - C N Jacinto
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - R S A Lima
- Department of Nephrology, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - M M V Girão
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - A T B M Fernandes
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil
| | - R J P Neto
- Department of Community Health, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil ; Department of Infectious Diseases, São José Infectious Diseases Hospital, Fortaleza, Ceará, Brazil
| | - G B Silva
- Department of Internal Medicine, School of Medicine, Federal University of Ceará, Fortaleza, Ceará, Brazil ; Department of Medicine, Health Sciences Center, University of Fortaleza, Fortaleza, Ceará, Brazil
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Schlichting D, Nöckler K, Bahn P, Luge E, Greiner M, Müller-Graf C, Mayer-Scholl A. Estimation of the sensitivity and specificity of a Leptospira spp. in-house ELISA through Bayesian modelling. Int J Med Microbiol 2015; 305:756-61. [PMID: 26358915 DOI: 10.1016/j.ijmm.2015.08.029] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
Abstract
The microscopic agglutination test (MAT) is still considered the gold standard for the diagnosis of leptospirosis, although studies have shown that the test is an imperfect gold standard for clinical samples and unsuitable for epidemiological studies. Here, test characteristics of an in-house ELISA were identified for both subclinical and clinical populations by Bayesian latent class models. A conditional dependence model for two diagnostic tests and two populations was adapted to analyse a clinical and a subclinical scenario, respectively. These Bayesian models were used to estimate the sensitivity and specificity of the in-house ELISA and the MAT as well as the prevalences. The Bayesian estimates of the in-house ELISA were: clinical sensitivity=83.0%, clinical specificity=98.5%, subclinical sensitivity=85.7% and subclinical specificity=99.1%. In contrast, the estimates of the MAT were: clinical sensitivity=65.6%, clinical specificity=97.7%, subclinical sensitivity 54.9% and subclinical specificity=97.3%. The results show the suitability of the in-house ELISA for both clinical investigations and epidemiological studies in mildly endemic areas.
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Affiliation(s)
- Daniela Schlichting
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany.
| | - Karsten Nöckler
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
| | - Peter Bahn
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
| | - Enno Luge
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
| | - Matthias Greiner
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
| | - Christine Müller-Graf
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
| | - Anne Mayer-Scholl
- Federal Institute for Risk Assessment (BfR), Consultant Laboratory for Leptospirosis, Max-Dohrn-Str. 8-10, 10589 Berlin, Germany
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Vieira ML, Nascimento ALTO. Interaction of spirochetes with the host fibrinolytic system and potential roles in pathogenesis. Crit Rev Microbiol 2015; 42:573-87. [PMID: 25914944 DOI: 10.3109/1040841x.2014.972336] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The pathogenic spirochetes Borrelia burgdorferi, B. hermsii, B. recurrentis, Treponema denticola and Leptospira spp. are the etiologic agents of Lyme disease, relapsing fever, periodontitis and leptospirosis, respectively. Lyme borreliosis is a multi-systemic disorder and the most prevalent tick-borne disease in the northern hemisphere. Tick-borne relapsing fever is persistent in endemic areas worldwide, representing a significant burden in some African regions. Periodontal disease, a chronic inflammatory disorder that often leads to tooth loss, is caused by several potential pathogens found in the oral cavity including T. denticola. Leptospirosis is considered the most widespread zoonosis, and the predominant human disease in tropical, undeveloped regions. What these diseases have in common is that they are a significant burden to healthcare costs in the absence of prophylactic measures. This review addresses the interaction of these spirochetes with the fibrinolytic system, plasminogen (Plg) binding to the surface of bacteria and the generation of plasmin (Pla) on their surface. The consequences on host-pathogen interactions when the spirochetes are endowed with this proteolytic activity are discussed on the basis of the results reported in the literature. Spirochetes equipped with Pla activity have been shown to degrade extracellular matrix (ECM) components, in addition to digesting fibrin, facilitating bacterial invasion and dissemination. Pla generation triggers the induction of matrix metalloproteases (MMPs) in a cascade of events that enhances the proteolytic capacity of the spirochetes. These activities in concert with the interference exerted by the Plg/Pla on the complement system - helping the bacteria to evade the immune system - should illuminate our understanding of the mechanisms involved in host infection.
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Steil D, Quandt A, Mayer-Scholl A, Sie JM, Löhr CV, Teifke JP. [Leptospirosis with necro-haemorrhagic cholecystitis in a Boxer puppy]. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2014; 42:399-405. [PMID: 25423604 DOI: 10.15654/tpk-140217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2013] [Accepted: 06/22/2014] [Indexed: 11/13/2022]
Abstract
A Boxer puppy from the island of Rügen, which was properly vaccinated according to its age, was presented with acute gastrointestinal symptoms. The presumptive diagnosis of leptospirosis with acute renal failure, hepatic damage, and jaundice was confirmed by seroconversion (increased titre to 1 : 800 in a non-vaccine serogroup 4 weeks after disease onset). Cholecystitis was diagnosed based on clinical symptoms and sonographic results. After an initial improvement, the puppy's condition deteriorated and cholecystectomy was performed. Histopathological diagnosis indicated a haemorrhagic necrotizing cholecystitis.
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Affiliation(s)
- D Steil
- Dr. Dorothee Steil, Tierarztpraxis Quandt und Bracke, An den Wurthen 26, 17489 Greifswald, E-Mail:
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Gracie R, Barcellos C, Magalhães M, Souza-Santos R, Barrocas PRG. Geographical scale effects on the analysis of leptospirosis determinants. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:10366-83. [PMID: 25310536 PMCID: PMC4210984 DOI: 10.3390/ijerph111010366] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/30/2014] [Revised: 09/03/2014] [Accepted: 09/10/2014] [Indexed: 01/03/2023]
Abstract
Leptospirosis displays a great diversity of routes of exposure, reservoirs, etiologic agents, and clinical symptoms. It occurs almost worldwide but its pattern of transmission varies depending where it happens. Climate change may increase the number of cases, especially in developing countries, like Brazil. Spatial analysis studies of leptospirosis have highlighted the importance of socioeconomic and environmental context. Hence, the choice of the geographical scale and unit of analysis used in the studies is pivotal, because it restricts the indicators available for the analysis and may bias the results. In this study, we evaluated which environmental and socioeconomic factors, typically used to characterize the risks of leptospirosis transmission, are more relevant at different geographical scales (i.e., regional, municipal, and local). Geographic Information Systems were used for data analysis. Correlations between leptospirosis incidence and several socioeconomic and environmental indicators were calculated at different geographical scales. At the regional scale, the strongest correlations were observed between leptospirosis incidence and the amount of people living in slums, or the percent of the area densely urbanized. At the municipal scale, there were no significant correlations. At the local level, the percent of the area prone to flooding best correlated with leptospirosis incidence.
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Affiliation(s)
- Renata Gracie
- FIOCRUZ, ICICT/LIS, Núcleo de Geoprocessamento, Avenida Brasil, 4365 Pavilhão Haity Moussatché, sala 231, Rio de Janeiro 21045-900, Brazil.
| | - Christovam Barcellos
- FIOCRUZ, ICICT/LIS, Núcleo de Geoprocessamento, Avenida Brasil, 4365 Pavilhão Hai ty Moussatché, sala 231- Manguinhos, Rio de Janeiro 21045-900, Brazil.
| | - Mônica Magalhães
- FIOCRUZ, ICICT/LIS, Núcleo de Geoprocessamento, Avenida Brasil, 4365 Pavilhão Hai ty Moussatché, sala 231- Manguinhos, Rio de Janeiro 21045-900, Brazil.
| | - Reinaldo Souza-Santos
- FIOCRUZ, ENSP/DENSP, Rua Leopoldo Bulhões, 1480 ENSP, sala 607-Manguinhos, Rio de Janeiro, ENSP 21041-210, Brazil.
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Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations. Environ Health Prev Med 2014. [PMID: 25239006 DOI: 10.1007/s12199‐014‐0395‐5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
During the last two decades, Sri Lanka, located close to the equator, has experienced an escalating incidence of chronic kidney disease (CKD) of unknown aetiology (CKDue) in dry zonal areas. Similar incidences of unusual CKDs have been reported in the dry zonal, agricultural areas of several other equatorial countries. In Sri Lanka, the incidence of CKDue is highest in the North Central Province (NCP), where approximately 45 % of the country's paddy fields are located. However, in recent years, the disease has spread into areas adjacent to as well as distant from the NCP. The cause of CKD in Sri Lanka is unknown, and may likely due to interactions of different potential agents; thus, CKD is of multi-factorial origin (CKD-mfo). These factors include, the negative effects from overuse of agrochemicals. Nevertheless, the potential interactions and synergism between probable agents have not been studied. This systematic review discusses the proposed hypotheses and causes of CKD-mfo in Sri Lanka, and ways to decrease the incidence of this disease and to eradicate it, and provide some recommendations. During the past decade, a number of groups have investigated this disorder using different methodologies and reported various correlations, but failed to find a cause. Research has focussed on the contamination of water with heavy metals, agrochemicals, hard water, algae, ionicity, climate change, and so forth. Nevertheless, the levels of any of the pollutants or conditions reported in water in NPC are inconsistent not correlated with the prevalence of the disease, and are too low to be the sole cause of CKD-mfo. Meanwhile, several nephrotoxins prevalent in the region, including medications, leptospirosis, toxic herbs, illicit alcohol, locally grown tobacco, and petrochemicals, as well as the effects of changed habits occured over the past four decades have not been studied to date. Taken together, the geographical distribution and overall findings indicate that combinations of factors and/or their interactions are likely to precipitate CKD-mfo, which kills more than 5,000 people annually in Sri Lanka; most victims are middle-aged male farmers. Much anecdotal evidence from this region suggests that consumption of contaminated water is the most likely source of this deadly disease. Although the aetiology is unknown, prevention of this "environmentally acquired" disease seems relatively straightforward. Solutions include (a) preventing environmental pollution, (b) stopping the irresponsible use and decreasing the usage of agrochemicals, and encouraging the use of environmentally friendly agricultural methods, (c) taking proper precautions when using agrochemicals and safe disposal of their containers, (d) changing the risky behaviour of farmers and educating them to preserve the environment, and (e) providing clean potable water to all affected regions. Implementing a well-coordinated, in-depth, region-wide, broad-based research study together with a long-term effective surveillance programme across the country is essential to curbing this disease. Unless firm actions are taken promptly, more than three million healthy people in the country, live in agricultural regions, are at risk for contracting CKD-mfo and succumb to premature deaths, which are preventable.
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Escalating chronic kidney diseases of multi-factorial origin in Sri Lanka: causes, solutions, and recommendations. Environ Health Prev Med 2014; 19:375-94. [PMID: 25239006 DOI: 10.1007/s12199-014-0395-5] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Accepted: 06/04/2014] [Indexed: 10/24/2022] Open
Abstract
During the last two decades, Sri Lanka, located close to the equator, has experienced an escalating incidence of chronic kidney disease (CKD) of unknown aetiology (CKDue) in dry zonal areas. Similar incidences of unusual CKDs have been reported in the dry zonal, agricultural areas of several other equatorial countries. In Sri Lanka, the incidence of CKDue is highest in the North Central Province (NCP), where approximately 45 % of the country's paddy fields are located. However, in recent years, the disease has spread into areas adjacent to as well as distant from the NCP. The cause of CKD in Sri Lanka is unknown, and may likely due to interactions of different potential agents; thus, CKD is of multi-factorial origin (CKD-mfo). These factors include, the negative effects from overuse of agrochemicals. Nevertheless, the potential interactions and synergism between probable agents have not been studied. This systematic review discusses the proposed hypotheses and causes of CKD-mfo in Sri Lanka, and ways to decrease the incidence of this disease and to eradicate it, and provide some recommendations. During the past decade, a number of groups have investigated this disorder using different methodologies and reported various correlations, but failed to find a cause. Research has focussed on the contamination of water with heavy metals, agrochemicals, hard water, algae, ionicity, climate change, and so forth. Nevertheless, the levels of any of the pollutants or conditions reported in water in NPC are inconsistent not correlated with the prevalence of the disease, and are too low to be the sole cause of CKD-mfo. Meanwhile, several nephrotoxins prevalent in the region, including medications, leptospirosis, toxic herbs, illicit alcohol, locally grown tobacco, and petrochemicals, as well as the effects of changed habits occured over the past four decades have not been studied to date. Taken together, the geographical distribution and overall findings indicate that combinations of factors and/or their interactions are likely to precipitate CKD-mfo, which kills more than 5,000 people annually in Sri Lanka; most victims are middle-aged male farmers. Much anecdotal evidence from this region suggests that consumption of contaminated water is the most likely source of this deadly disease. Although the aetiology is unknown, prevention of this "environmentally acquired" disease seems relatively straightforward. Solutions include (a) preventing environmental pollution, (b) stopping the irresponsible use and decreasing the usage of agrochemicals, and encouraging the use of environmentally friendly agricultural methods, (c) taking proper precautions when using agrochemicals and safe disposal of their containers, (d) changing the risky behaviour of farmers and educating them to preserve the environment, and (e) providing clean potable water to all affected regions. Implementing a well-coordinated, in-depth, region-wide, broad-based research study together with a long-term effective surveillance programme across the country is essential to curbing this disease. Unless firm actions are taken promptly, more than three million healthy people in the country, live in agricultural regions, are at risk for contracting CKD-mfo and succumb to premature deaths, which are preventable.
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Ptak CP, Hsieh CL, Lin YP, Maltsev AS, Raman R, Sharma Y, Oswald RE, Chang YF. NMR solution structure of the terminal immunoglobulin-like domain from the leptospira host-interacting outer membrane protein, LigB. Biochemistry 2014; 53:5249-60. [PMID: 25068811 PMCID: PMC4139157 DOI: 10.1021/bi500669u] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
A number of surface proteins specific to pathogenic strains of Leptospira have been identified. The Lig protein family has shown promise as a marker in typing leptospiral isolates for pathogenesis and as an antigen in vaccines. We used NMR spectroscopy to solve the solution structure of the twelfth immunoglobulin-like (Ig-like) repeat domain from LigB (LigB-12). The fold is similar to that of other bacterial Ig-like domains and comprised mainly of β-strands that form a β-sandwich based on a Greek-key folding arrangement. Based on sequence analysis and conservation of structurally important residues, homology models for the other LigB Ig-like domains were generated. The set of LigB models illustrates the electrostatic differences between the domains as well as the possible interactions between neighboring domains. Understanding the structure of the extracellular portion of LigB and related proteins is important for developing diagnostic methods and new therapeutics directed toward leptospirosis.
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Affiliation(s)
- Christopher P Ptak
- Department of Population Medicine and Diagnostic Sciences and ‡Department of Molecular Medicine, College of Veterinary Medicine, Cornell University , Ithaca, New York 14853, United States
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Leptospirosis in vellore: a clinical and serological study. Int J Microbiol 2014; 2014:643940. [PMID: 25050124 PMCID: PMC4094863 DOI: 10.1155/2014/643940] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2014] [Accepted: 06/09/2014] [Indexed: 12/02/2022] Open
Abstract
Leptospirosis is a severe spirochetal zoonosis in the world. It is considered an occupational disease of persons engaged in agriculture, sewage works, forestry, and animal slaughtering. A study was conducted with an objective of assessing the seroprevalence of leptospirosis in and around Vellore district, Tamil Nadu. The study was based on the signs and symptoms of the patients reporting fever in Vellore Municipal Clinic (Urban Malarial Scheme). Blood samples were collected from 129 patients. Animal studies were conducted from 24 rodents captured form the market place of the Vellore municipality. In the ZET (Zonal Entomological Team, Vellore) Laboratory the sera were examined by macroscopic slide agglutination test (MSAT). In the MAST, totally 10 positive leptospiral cases from human beings and 10 positive leptospiral cases from rats (Rattus rattus and Rattus norvegicus) were found out. Then both positive cases of leptospiral vials were labeled, sealed, and sent to the Leptospirosis Research Laboratory, Madhavaram, Chennai, for further serovars examination. Among the various serovars identified autumnalis was more prevalent. Our findings showed that the age groups between 15 and 55 years showed more susceptibility. Particularly the adults were more infected. The majority of seropositive individuals in the cases had only subclinical infection. Rodents were abundant and contributed to enzootic and endemic prevalence of leptospirosis.
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Legris T, Jaffar-Bandjee MC, Favre O, Lefrançois N, Genin R, Ragot C, Fernandez C, Reboux AH. Ameboma: an unusual cause of gastrointestinal bleeding during severe leptospirosis. BMC Infect Dis 2014; 14:299. [PMID: 24894109 PMCID: PMC4047549 DOI: 10.1186/1471-2334-14-299] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 05/21/2014] [Indexed: 11/14/2022] Open
Abstract
Background Severe leptospirosis occurs mainly in a tropical environment and includes icterus, acute renal failure and hemorrhages. These bleedings, which are mainly a consequence of acute homeostatic disturbances, can also reveal simultaneous diseases. Coinfections with other tropical diseases have been previously reported during leptospirosis. To our knowledge, invasive amebiasis, which can induce gastrointestinal bleedings, has never been described in the course of severe leptospirosis. Case presentation In this report, we describe a case of a 60 year-old man living in Reunion Island (Indian Ocean, France) admitted to our intensive care unit for severe Leptospira interrogans serovar icterohaemorrhagiae infection with neurological, renal, liver and hematological involvement. Two lower gastrointestinal bleedings occurred 7 and 15 days after admission. The first episode was promoted by hemostatic disturbances while the second bleeding occurred during low-dose heparin therapy. Colonoscopy revealed a pseudo-tumoral inflammatory mass of the recto-sigmoid junction. Histological examination found trophozoites inside mucinous exudate suggestive of Entamoeba histolytica. Amoebic serology was strongly positive whereas careful detection of cysts or trophozoites on saline-wet mount was negative in three consecutive samples of stools. Amoxicillin followed by metronidazole therapy, combined with supportive care, led to an improvement in the clinical and biological patient’s condition and endoscopic appearances. Conclusion Clinicians should be aware that gastrointestinal bleeding during severe leptospirosis could not solely be the consequences of hemostatic disturbances. Careful endoscopic evaluation that may reveal curable coinfections should also be considered.
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Affiliation(s)
- Tristan Legris
- Service de Néphrologie, Dialyse et Transplantation Rénale, Centre Hospitalier Universitaire Felix Guyon, Saint-Denis, La Réunion, France.
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Though not reservoirs, dogs might transmit Leptospira in New Caledonia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2014; 11:4316-25. [PMID: 24747539 PMCID: PMC4025015 DOI: 10.3390/ijerph110404316] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/22/2014] [Revised: 03/26/2014] [Accepted: 03/28/2014] [Indexed: 11/16/2022]
Abstract
Leptospira has been a major public health concern in New Caledonia for decades. However, few multidisciplinary studies addressing the zoonotic pattern of this disease were conducted so far. Here, pig, deer and dog samples were collected. Analyses were performed using molecular detection and genotyping. Serological analyses were also performed for dogs. Our results suggest that deer are a reservoir of L. borgpetersenii Hardjobovis and pigs a reservoir of L. interrogans Pomona. Interestingly, 4.4% of dogs were renal carriers of Leptospira. In dog populations, MAT results confirmed the circulation of the same Leptospira serogroups involved in human cases. Even if not reservoirs, dogs might be of significance in human contamination by making an epidemiological link between wild or feral reservoirs and humans. Dogs could bring pathogens back home, shedding Leptospira via their urine and in turn increasing the risk of human contamination. We propose to consider dog as a vector, particularly in rural areas where seroprevalence is significantly higher than urban areas. Our results highlight the importance of animal health in improving leptospirosis prevention in a One Health approach.
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Cermakova Z, Kucerova P, Pliskova L, Kubickova P. Real-time PCR method for the detection of the gene encoding surface lipoprotein LipL32 of pathogenic Leptospira: use in the laboratory diagnosis of the acute form of leptospirosis. ACTA ACUST UNITED AC 2014; 45:593-9. [PMID: 23848450 DOI: 10.3109/00365548.2013.795656] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
BACKGROUND The aims of this work were to replace the obsolete PCR method for the laboratory diagnosis of the acute form of leptospirosis using the G1, G2 and B64 I, B64 II primers, and to improve the PCR detection time. METHODS We introduced a real-time PCR method for the detection of the gene encoding the surface lipoprotein LipL32 of pathogenic Leptospira into our laboratory diagnosis of the acute form of leptospirosis. The positive and negative analytical specificities of the real-time PCR method were both equal to 100%; the detection limit was determined to be 1-5 genome copies/1 ml of liquid biological material. The method was further validated on 230 laboratory strains of leptospires. RESULTS All laboratory strains of pathogenic Leptospira were evaluated as LipL32-positive and all non-pathogenic strains as LipL32-negative. In addition, 455 biological materials (253 plasma, 121 urine, 72 cerebrospinal fluid (CSF), 7 bronchoalveolar lavage, and 2 sputum) from 295 patients with suspected leptospirosis were examined. From this set of patients, 9 were evaluated to be LipL32-positive, from 15 positive biological materials (10 urine, 4 blood plasma, and 1 CSF). CONCLUSIONS This real-time PCR method for the detection of the gene encoding the surface lipoprotein LipL32 is a reliable, sensitive, and rapid method for the detection of the acute form of leptospirosis.
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Affiliation(s)
- Zuzana Cermakova
- Department of Clinical Microbiology, Charles University in Prague, Faculty of Medicine in Hradec Kralove and University Hospital Hradec Kralove, Hradec Kralove, Czech Republic
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Daher EF, Silva GB, Silveira CO, Falcão FS, Alves MP, Mota JAAA, Lima JB, Mota RMS, Vieira APF, Pires RDJ, Libório AB. Factors associated with thrombocytopenia in severe leptospirosis (Weil's disease). Clinics (Sao Paulo) 2014; 69:106-10. [PMID: 24519201 PMCID: PMC3912336 DOI: 10.6061/clinics/2014(02)06] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Accepted: 07/27/2013] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE This study was conducted to investigate factors associated with thrombocytopenia in a large cohort of patients with leptospirosis in an endemic area. METHODS This retrospective study included 374 consecutive patients with leptospirosis who were admitted to tertiary hospitals in Fortaleza, Brazil. All patients had a diagnosis of severe leptospirosis (Weil's disease). Acute kidney injury was defined according to the RIFLE criteria. Thrombocytopenia was defined as a platelet count <100,000/mm3. RESULTS A total of 374 patients were included, with a mean age of 36.1 ± 15.5 years, and 83.4% were male. Thrombocytopenia was present at the time of hospital admission in 200 cases (53.5%), and it developed during the hospital stay in 150 cases (40.3%). The patients with thrombocytopenia had higher frequencies of dehydration (53% vs. 35.3%, p=0.001), epistaxis (5.7% vs. 0.8%, p=0.033), hematemesis (13% vs. 4.6%, p=0.006), myalgia (91.5% vs. 84.5%, p=0.038), hematuria (54.8% vs. 37.6%, p=0.011), metabolic acidosis (18% vs. 9.2%, p=0.016) and hypoalbuminemia (17.8% vs. 7.5%, p=0.005). The independent risk factors associated with thrombocytopenia during the hospital stay were lengthy disease (OR: 1.2, p=0.001) and acute kidney injury (OR: 6.6, p=0.004). Mortality was not associated with thrombocytopenia at admission (12.5% vs. 12.6%, p=1.000) or during the hospital stay (12.6% vs. 11.3%, p=0.748). CONCLUSIONS Thrombocytopenia is a frequent complication in leptospirosis, and this condition was present in more than half of patients at the time of hospital admission. Lengthy disease and acute kidney injury are risk factors for thrombocytopenia. There was no significant association between thrombocytopenia and mortality.
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Affiliation(s)
- Elizabeth F Daher
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Geraldo B Silva
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Charles O Silveira
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Felipe S Falcão
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Marília P Alves
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Jório A A A Mota
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Joyce B Lima
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Rosa M S Mota
- Federal University of Ceará, Department of Statistics, FortalezaCE, Brazil, Federal University of Ceará, Department of Statistics, Fortaleza/CE, Brazil
| | - Ana Patrícia F Vieira
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
| | - Roberto da Justa Pires
- Federal University of Ceará, Department of Community Health, FortalezaCE, Brazil, Federal University of Ceará, Department of Community Health, Fortaleza/CE, Brazil
| | - Alexandre B Libório
- Federal University of Ceará, School of Medicine, School of Medicine, Department of Internal Medicine, Division of Nephrology, FortalezaCE, Brazil, Federal University of Ceará, School of Medicine, Department of Internal Medicine, Division of Nephrology, Fortaleza/CE, Brazil
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Hassan L. Emerging Zoonoses in Domesticated Livestock of Southeast Asia. ENCYCLOPEDIA OF AGRICULTURE AND FOOD SYSTEMS 2014. [PMCID: PMC7152182 DOI: 10.1016/b978-0-444-52512-3.00216-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Southeast Asia, identified as one of the hotspot for emerging and reemerging diseases is an area of emerging market with doubling population size within the next few years. The livestock industry is growing rapidly to cater for the population need via intensification and various diversification methods. This article discusses a few relevant emerging and emerging zoonoses within the past two decades and highlights the impact of these diseases to the animal industry and public health in the region.
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Halliday JEB, Knobel DL, Allan KJ, de C. Bronsvoort BM, Handel I, Agwanda B, Cutler SJ, Olack B, Ahmed A, Hartskeerl RA, Njenga MK, Cleaveland S, Breiman RF. Urban leptospirosis in Africa: a cross-sectional survey of Leptospira infection in rodents in the Kibera urban settlement, Nairobi, Kenya. Am J Trop Med Hyg 2013; 89:1095-1102. [PMID: 24080637 PMCID: PMC3854886 DOI: 10.4269/ajtmh.13-0415] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2013] [Accepted: 08/27/2013] [Indexed: 12/03/2022] Open
Abstract
Leptospirosis is a widespread but under-reported cause of morbidity and mortality. Global re-emergence of leptospirosis has been associated with the growth of informal urban settlements in which rodents are thought to be important reservoir hosts. Understanding the multi-host epidemiology of leptospirosis is essential to control and prevent disease. A cross-sectional survey of rodents in the Kibera settlement in Nairobi, Kenya was conducted in September-October 2008 to demonstrate the presence of pathogenic leptospires. A real-time quantitative polymerase chain reaction showed that 41 (18.3%) of 224 rodents carried pathogenic leptospires in their kidneys, and sequence data identified Leptospira interrogans and L. kirschneri in this population. Rodents of the genus Mus (37 of 185) were significantly more likely to be positive than those of the genus Rattus (4 of 39; odds ratio = 15.03). Questionnaire data showed frequent contact between humans and rodents in Kibera. This study emphasizes the need to quantify the public health impacts of this neglected disease at this and other urban sites in Africa.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - Sarah Cleaveland
- Boyd Orr Centre for Population and Ecosystem Health, Institute of Biodiversity, Animal Health and Comparative Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, United Kingdom; Department of Veterinary Tropical Diseases, Faculty of Veterinary Science, University of Pretoria, Pretoria, South Africa; The Roslin Institute at the Royal (Dick) School of Veterinary Studies, University of Edinburgh, Easter Bush, Midlothian, United Kingdom; National Museums of Kenya, Nairobi, Kenya; School of Health, Sport and Biosciences, University of East London, London, United Kingdom; Kenya Medical Research Institute/Centers for Disease Control and Prevention Public Health and Research Collaboration, Kisumu and Nairobi, Kenya; Global Disease Detection Division, Centers for Disease Control and Prevention–Kenya, Nairobi, Kenya; World Health Organization/Food and Agricultural Organization/World Organisation for Animal Health and National Leptospirosis Reference Centre, KIT Biomedical Research, Amsterdam, The Netherlands
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Chirathaworn C, Kongpan S. Immune responses to Leptospira infection: roles as biomarkers for disease severity. Braz J Infect Dis 2013; 18:77-81. [PMID: 24275371 PMCID: PMC9425245 DOI: 10.1016/j.bjid.2013.08.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2013] [Revised: 08/18/2013] [Accepted: 08/27/2013] [Indexed: 12/12/2022] Open
Abstract
Various leptospiral components have been identified and shown to be involved in tissue destruction. In addition, immune responses to leptospires have been implicated in target organ damages in severe leptospirosis cases. Several inflammatory mediators were shown to be higher in susceptible animals than in resistant hosts. Moreover, cytokines/chemokines and serum proteins induced following Leptospira infection were suggested to be biomarkers for disease severity in human leptospirosis. This review focuses on the role of immune responses in the severity of leptospirosis. Studies in both animal models and humans are discussed.
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Affiliation(s)
- Chintana Chirathaworn
- Department of Microbiology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
| | - Sutthikarn Kongpan
- Master of Science Program in Medical Sciences, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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